<!--COLUMN 1-->
<div class="ThreeColGrid_c1">
<div id="output" class="myAvatar">
<?php 
echo '<img src="'.Router::url('/').'app/webroot/img/avatar.jpg" width="100" alt="Locum">';
?>
</div>

<a href="javascript:void(0)" id='UploadImage' class="TitleFive">edit image</a> 

<div class="hide" id="upload-block">
<?php echo $form->create('Store', array('action'=>'upload_avatar','id'=>'FileUploader','type'=>'post','enctype' => 'multipart/form-data'));?>
<?php echo $form->input('mFile',array('label'=>'','div'=>'','type'=>'file','size'=>2)); ?>
<button type="submit" class="red-button" id="uploadButton">Upload</button>
<?php echo $form->end()?>
</div>

</div>
<!--COLUMN 1-->

<!--COLUMN 2-->
<div class="ThreeColGrid_c2">
<?php $session->flash(); ?>    
<?php echo $form->create('Store',array('action' => 'add'));?>  
<?php echo $form->input('id',array('label'=>'','div'=>'','type'=>'hidden')); ?>
<?php echo $form->input('Avatar',array('label'=>'','div'=>'','type'=>'hidden')); ?>

<table border="0" cellspacing="0" cellpadding="0">

<tr>
<td valign="top" width="200"><b>Username</b></td>
<td valign="top" width="200"><?php echo $form->input('Username',array('label'=>'','div'=>'')); ?></td>
</tr>
    
<tr>
<td valign="top" width="200"><b>Password</b></td>
<td valign="top" width="200"><?php echo $form->input('Password',array('label'=>false,'type'=>'password')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Pharmacy name</b></td>
<td valign="top" width="200"><?php echo $form->input('PharmacyName',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Address</td>
<td valign="top" width="200"><?php echo $form->input('Address', array('type' => 'textarea','label'=>'','escape' => false,'rows'=>5,'cols'=>30));?></td>
</tr>

<tr>
<td valign="top" width="200"><b>County</b></td>
<td valign="top" width="200">
<select name="data[Store][Country_id]" id="UserCountry">
<?php
                      $temp ='';
                      foreach ($GLOBALS['Counties'] as $group=>$countries)
                      {
                           if($group != $temp)
                           {
                                echo  '<optgroup label="'.$group.'">'  ;
                           }
                           foreach ($countries as $k=>$country) 
                           {
                                echo  ' <option value="'.$k.'">'.$country.'</option>'   ;
                           }
                           
                           $temp = $group;
                      }

                
?>
</select>
</td>
</tr>

<tr>
<td valign="top" width="200"><b>Postcode</b></td>
<td valign="top" width="200"><?php echo $form->input('Postcode',array('label'=>'','div'=>'')); ?>
<span class="noteTwo">Postcode + space + street (Ex: CW12 2AT)</span>   
</td>
</tr>

<tr>
<td valign="top" width="200"><b>Email</b></td>
<td valign="top" width="200"><?php echo $form->input('Email',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Telephone</b></td>
<td valign="top" width="200"><?php echo $form->input('Telephone',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Fax</b></td>
<td valign="top" width="200"><?php echo $form->input('Fax',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>GPHC Number</b></td>
<td valign="top" width="200"><?php echo $form->input('GPHCNumber',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Pharmacist reg date</span></td>
<td valign="top" width="200"><?php echo $form->input('DateOfPharmacist',array('type'=>'text','label'=>'','div'=>'')); ?></td>
</tr>
  
<tr>
<td valign="top" width="200"><b>IT compatibility</span></td>
<td valign="top" width="200"><?php echo $form->select('ITCompatibility',$GLOBALS['ITCompatibility'],null,array('multiple'=>true,'label'=>'','div'=>''),false); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>EPS1 ready</b></td>
<td valign="top" width="200">Yes <?php echo $form->checkbox('EPS1Ready',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>EPS2 ready</b></td>
<td valign="top" width="200">Yes <?php echo $form->checkbox('EPS2Ready',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Opening hours</b></td>
<td valign="top" width="200">
<table border="0" cellspacing="0" cellpadding="0">
<?php foreach($GLOBALS['Days'] as $day){?>
	<tr>
		<td valign="top" width="200"><?php echo $day.':'?></td>
		<td valign="top" width="200">
			<select name = "data[Store][<?php echo $day?>][from]">  
			<?php foreach($GLOBALS['OpeningHours'] as $openingHours){?>
				<option value="<?php echo $openingHours?>" <?php if(trim($openingHours)==='5:30 AM') echo 'selected=selected'?>><?php echo $openingHours?></option>
			<?php }?>
			</select> -
		</td>
		<td valign="top" width="200">
			<select name = "data[Store][<?php echo $day?>][to]">   
			<?php foreach($GLOBALS['OpeningHours'] as $openingHours){?>
				<option value="<?php echo $openingHours?>" <?php if(trim($openingHours)==='11:30 PM') echo 'selected=selected'?>><?php echo $openingHours?></option>
			<?php }?>    
		</select>
		</td>
	</tr>
<?php } ?>
</table>

</td>
</tr>

<tr>
<td valign="top" width="200"><b>Lunch closure</b></td>
<td valign="top" width="200"><?php echo $form->checkbox('LunchClosure',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Free parking</b></td>
<td valign="top" width="200"><?php echo $form->checkbox('FreeParking',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Prescription items</b></td>
<td valign="top" width="200">
<?php echo $form->select('PrescriptionItems',$GLOBALS['PrescriptionItems'],null,array('label'=>'','div'=>''),false); ?>
</td>
</tr>

<tr>
<td valign="top" width="200"><b>Staff</b></td>
<td valign="top" width="200"><?php echo $form->select('Staff',$GLOBALS['Staff'],null,array('multiple'=>true,'label'=>'','div'=>''),false); ?>
<span class="noteTwo">Ctrl + click to select multiple items</span>   
</td>          
</tr>

<tr>
<td valign="top" width="200"><b>Consultation room</b></td>
<td valign="top" width="200">Yes <?php echo $form->checkbox('ConsultationRoom',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Community dossette patients #</b></td>
<td valign="top" width="200"><?php echo $form->input('CommunityDossettePatients',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Servicing of care homes #</b></td>
<td valign="top" width="200"><?php echo $form->input('Servicing',array('label'=>'','div'=>'')); ?></td>
</tr>

<tr>
<td valign="top" width="200"><b>Essential services</b></td>
<td valign="top" width="200"><?php echo $form->select('EssentialServices',$GLOBALS['EssentialServices'],null,array('label'=>'','div'=>'','multiple'=>true),false); ?>
<span class="noteTwo">Ctrl + click to select multiple items</span> 
</td>          
</tr>

<tr>
<td valign="top" width="200"><b>Advanced services</b></td>
<td valign="top" width="200"><?php echo $form->select('AdvancedServices',$GLOBALS['AdvancedServices'],null,array('label'=>'','div'=>'','multiple'=>true),false); ?>
<span class="noteTwo">Ctrl + click to select multiple items</span> 
</td>          
</tr>

<tr>
<td valign="top" width="200"><b>Enhanced services</b></td>
<td valign="top" width="200"><?php echo $form->select('EnhancedServices',$GLOBALS['EnhancedServices'],null,array('label'=>'','div'=>'','multiple'=>true),false); ?>
<span class="noteTwo">Ctrl + click to select multiple items</span> 
</td>          
</tr>

<tr>
<td valign="top" width="200"><b>Patient Group Directives</b></td>
<td valign="top" width="200">
<?php echo $form->textarea('PatientGroupDirectives',array('label'=>'','div'=>'','cols'=>30,'rows'=>5)); ?>
</td>
</tr>

<tr>
<td valign="top" width="200">&nbsp;</td>
<td valign="top" width="200"><?php echo $form->submit();?></td>
</tr>

</table>

<?php echo $form->end(); ?>
</div>
<!--COLUMN 2-->

<!--COLUMN 3-->
<div class="ThreeColGrid_c3">
<h6 class="TitleFive">Locum Search</h6>
<?php
	if($UserType == 3)
		echo $this->element('search');
	else
		echo $this->element('search_for_pharmacy');
?>
</div>
<!--COLUMN 3-->